Evaluation of ChatGPT as a Tool for Answering Clinical Questions in Pharmacy Practice.

Background: In the healthcare field, there has been a growing interest in using artificial intelligence (AI)-powered tools to assist healthcare professionals, including pharmacists, in their daily tasks. Objectives: To provide commentary and insight into the potential for generative AI language models such as ChatGPT as a tool for answering practice-based, clinical questions and the challenges that need to be addressed before implementation in pharmacy practice settings. Methods: To assess ChatGPT, pharmacy-based questions were prompted to ChatGPT (Version 3.5; free version) and responses were recorded. Question types included 6 drug information questions, 6 enhanced prompt drug information questions, 5 patient case questions, 5 calculations questions, and 10 drug knowledge questions (e.g., top 200 drugs). After all responses were collected, ChatGPT responses were assessed for appropriateness. Results: ChatGPT responses were generated from 32 questions in 5 categories and evaluated on a total of 44 possible points. Among all ChatGPT responses and categories, the overall score was 21 of 44 points (47.73%). ChatGPT scored higher in pharmacy calculation (100%), drug information (83%), and top 200 drugs (80%) categories and lower in drug information enhanced prompt (33%) and patient case (20%) categories. Conclusion: This study suggests that ChatGPT has limited success as a tool to answer pharmacy-based questions. ChatGPT scored higher in calculation and multiple-choice questions but scored lower in drug information and patient case questions, generating misleading or fictional answers and citations.

An Opportunity to Integrate Cultural Sensitivity Training Into the Doctor of Pharmacy Curriculum.

Instructors of pharmacy skills-based laboratory courses are positioned to prepare students to be practice-ready practitioners through use of hands-on instructional activities essential for pharmacists. This commentary explores an approach to developing cultural sensitivity in pharmacy students, a skill which is reflected in Accreditation Council for Pharmacy Education (ACPE) Standard 3.5 and viewed by the authors as a critical skill for all healthcare practitioners. This commentary challenges the Academy to develop best practices for promoting cultural sensitivity in student-learners with the goal of producing students aware of how their own experiences may influence health inequities. The authors propose, using the model of self-efficacy theory as a framework, that skills-based pharmacy education is an ideal platform for cultural sensitivity skill development and engagement because of its ability to go beyond knowledge attainment and influence student abilities, behaviors, and attitudes. The authors' recommendations include that members of the Academy self-assess personal and institutional cultural sensitivity, ensure integration of cultural sensitivity in curriculum, use self-efficacy theory as a guide to integrate best practices for providing culturally sensitive care in laboratory activities, and develop best practices.

Educating Pharmacy Students About Underserved Populations Using Patient Speakers and Simulation Activities.

Objective. To assess the impact of the Patient Voices series on Doctor of Pharmacy (PharmD) students.Methods. A series of patient speakers and integrated simulation activities focused on underserved populations, otherwise known as the Patient Voices series, was embedded into a pharmacy skills laboratory curriculum. First-year PharmD students' self-ratings of confidence were compared on pre- and post-course surveys. Using evaluations from first-year introductory pharmacy practice experiences (IPPEs), student self-evaluation data were compared to preceptor evaluations of student performance. Open-ended responses to course evaluations from first- and second-year PharmD students and student reflections from third-year PharmD students were assessed using conventional content analysis to identify and characterize student perceptions.Results. Significant increases were observed in first-year students' confidence to show empathy (mean, 4.2 to 4.7) and to interact with patients from underserved communities (mean, 2.2 to 4.2). Preceptor ratings of students' empathy were consistent with the students' self-rated abilities, while students' self-ratings on cultural sensitivity were higher than the preceptors' ratings. Qualitative analysis of course evaluation surveys and reflections revealed common themes identified by students, such as understanding different perspectives, increased empathy for patients, and the value of including this content in the curriculum.Conclusion. Student confidence to interact with patients from a variety of underserved populations increased following introduction of the Patient Voices series into the PharmD curriculum. Students perceived the series to be a valuable learning experience.

Pharmacist impact on pediatric vaccination errors and missed opportunities in the setting of clinical decision support.

OBJECTIVE: To determine pharmacist impact on vaccination errors and missed opportunities in the pediatric primary care setting with the presence of clinical decision support (CDS) by comparing a clinic with a pharmacist and CDS to a clinic with CDS alone. DESIGN: A retrospective chart review of patients' electronic medical records compared vaccination errors and missed opportunities between 2 pediatric primary care clinics. SETTING: Two urban, pediatric primary care clinics were selected for the study. PARTICIPANTS: Encounters were included in the analysis for children presenting for any visit over a 3-month period. INTERVENTION: The intervention clinic had a full-time clinical pharmacist and CDS. The comparison clinic had CDS alone. MAIN OUTCOME MEASURES: Vaccination errors were defined as follows: doses administered before minimum recommended age, doses administered before minimum recommended dosing interval, unnecessary doses, and invalid doses for a combination of these reasons. Missed opportunities were defined as vaccine doses due at the date of encounter but not administered, without documented reason for vaccination delay or refusal by provider or patient. The likelihood of missing an opportunity was also assessed for patient age, visit type, and provider type. RESULTS: One thousand and twenty patient encounters were randomly selected and reviewed. The vaccination error rate was 0.4% in the comparison group and 0% in the intervention group (P = 0.4995). The number of encounters with a missed opportunity was significantly higher in the comparison group compared with the intervention group (51 vs. 30 encounters with missed opportunities; P = 0.015; adjusted odds ratio, 2.14 [95% CI 1.3-35]). CONCLUSION: Although the use of CDS results in a low rate of vaccination errors, technology cannot be solely relied on for vaccination recommendations in the pediatric population because of the rigidity of CDS configuration. Pharmacists continue to play a vital role to ensure that children are appropriately vaccinated in the primary care setting.

Impact of pharmacist integration in a pediatric primary care clinic on vaccination errors: a retrospective review.

OBJECTIVE: To measure the impact of ambulatory clinical pharmacist integration in a pediatric primary care clinic on vaccination error rates and to evaluate missed opportunities. METHODS: A retrospective, quasi-experimental review of electronic medical records of visit encounters during a 3-month period compared vaccine error rates and missed opportunities between two pediatric residency primary care clinics. The intervention clinic has a full-time ambulatory clinical pharmacist integrated into the health care team. Pharmacy services were not provided at the comparison clinic. A vaccine error was defined as follows: doses administered before minimum recommended age, doses administered before minimum recommended spacing from a previous dose, doses administered unnecessarily, live virus vaccination administered too close to a previous live vaccine, and doses invalid for combinations of these reasons. RESULTS: 900 encounters were randomly selected and reviewed. The error rate was found to be 0.28% in the intervention clinic and 2.7% in the comparison clinic. The difference in error rates was found to be significant (P = 0.0021). The number of encounters with greater than or equal to one missed opportunity was significantly higher in the comparison clinic compared with the intervention clinic (29.3% vs. 10.2%; P <0.0001). CONCLUSION: The pediatric primary care clinic with a pharmacist had reductions in vaccination errors as well as missed opportunities. Pharmacists play a key role in the pediatric primary care team to improve the appropriate use of vaccines.